Supportive therapies are those aimed at improving patients’ symptoms and preventing complications that would further worsen their quality of life.
These therapies include:
- Classic supportive medical therapies: such as pain therapy, nutritional support, hydration, sedation, blood transfusions in the event of severe anemia, and the removal of peritoneal or pleural liquid to relieve the symptoms caused by these complications.
- Surgery: such as intestinal bypass in patients with intestinal sub-occlusion (in order to avoid complete intestinal blockage: one of the worst terminal conditions), or orthopedic or neurosurgical operations to remove bone metastases, which are very painful.
- Radiology, gastroenterology or pulmonary procedures: e.g. in lung cancer, removing fluid from the lungs, or shrinking tumor masses in the large bronchi by means of laser therapy, can improve the patient’s breathing. Placing stents (metal tubes) in the biliary or urinary tracts prevents blockage by tumor masses, keeping the liver and kidneys working.
Naturally, all these palliative strategies can also be used, together with anti-cancer therapies, well before the terminal stage of the disease.
Palliative surgery or radiology procedures can sometimes remedy a critical situation and the patient can “come back into the game”. I.e., thanks to these “salvage” operations, other anti-cancer therapies can be tried.
However, when every possibility of stopping the tumor by means of anti-cancer therapy has been used up, resorting to invasive palliative procedures requires further consideration.
- There are no restrictions on the use of supportive medical therapies. They are used whenever they are needed, even when death is only hours away.
- By contrast, with regard to invasive procedures (often painful), which always carry a risk of possible complications, we need to ask ourselves whether it is appropriate to perform them. There are specific guidelines on the use of invasive palliative techniques, but the decision is always very difficult. (ANTI-CANCER THERAPIES NO LONGER WORK)
In these difficult and tragic circumstances, decisions must be based on calmness, wisdom, experience and the alliance of the doctor, the patient and his family members.